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BU - PS 371 - Study Guide Exam 2 - Study Guide

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BU - PS 371 - Study Guide Exam 2 - Study Guide

School: Boston University
Department: OTHER
Course: Abnormal Psychology
Professor: Donna Pincus
Term: Spring 2017
Tags: abnormal psych
Name: Study Guide Exam 2
Description: These notes cover what will be on our next exam.
Uploaded: 03/31/2017
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background image Exam Two Study Guide    Red: confirmed on exam    Table of Contents ​______________________________________________________________  General Information 
Unit 6: Somatic Symptom and Related Disorders and Dissociative Disorders 
Unit 7: Mood Disorders 
Unit 8: Eating Disorders 
Unit 9: Sleep-Wake Disorders 
Unit 10: Physical Disorders- Pain 
Unit 11: Physical Disorders- Health Psychology 
 
General Information  Date: ​ 4/4/2017, 11:00 am   Format: ​ 50 multiple choice questions  Weight: ​ 30% of final grade   Material:  ● Lectures:  ​3/2-3/30  ● Textbook:  ​Chapters 6-9    
______________________________________________________________________________ 
 
Unit 6: Somatic Symptom and Related Disorders and Dissociative Disorders    Highlight of Changes in Somatic Symptom and Related Disorders in DSM-5  ● The following DSM-4 diagnoses are  not present  in DSM-5 (although some have been  altered to become one or more new diagnoses)  ○ Hypochondriasis  
○ Somatization disorder, pain disorder, undifferentiated somatoform disorder 
● New disorders added to DSM-5  ○ Illness anxiety disorder  ■ Severe anxiety about possibility of having or developing a disease;  physical symptoms may be mild or nonexistent   ○ Somatic symptom disorder  ■ Excessive focus on physical symptoms, severe somatic complaints, no  medical basis for complaints  ○ Psychological factors affecting other medical conditions  ■ I.e. anxiety in a panic disorder might worsen a person’s asthma 
background image ○ Pain disorder is now classified as somatic symptom with disorder with  predominant pain  ● BDD was classified as somatic symptom disorder in DSM 4 but is now OCD and related  disorders   
An Overview of Somatic Symptom Disorders 
● Soma- meaning body  ○ Overly preoccupied with health or body appearance  
○ Person has physical complaints- with no identifiable medical condition causing 
them   ● Types of DSM-5 Somatic Symptom Disorders  ○ Illness Anxiety Disorder  ■ anxiety focused on the possibility of having a serious disease; calls doc a  lot, take medication; may not have physical symptoms at all, or they may 
be mild 
○ Somatic Symptom Disorder  ■ Focus is not on having a disease, but rather on the symptoms themselves;  continually feel weak and ill; life revolves around the symptoms; no 
medical basis for symptoms  
○ Psychological factors affecting other medical conditions  
○ Conversion disorder  
■ Has to do with physical malfunctioning such as paralysis, blindness, or  difficulty speaking (aphonia), without any physical or organic pathology 
to account for the malfunction 
 
Illness Anxiety Disorder: An Overview 
● Overview and Defining Features  ○ “Hypochondriasis” has been eliminated as a disorder  ■ Name was perceived as pejorative 
■ Not conducive to an effective therapeutic relationship 
○ Most individuals who would previously have been diagnosed with  hypochondriasis have significant somatic symptoms in addition to their high 
health anxiety, and would now receive a DSM-5 diagnosis of somatic symptom 
disorder 
○ Shares many features with anxiety and mood disorders- especially panic disorder  ■ Similar age of onset, runs in families  ○ Anxiety and mood disorders are frequently comorbid with illness anxiety disorder  
Disease conviction  is a core feature of illness anxiety disorder 
background image ○ Panic disorder may fear and misinterpret physical symptoms while IAD focus on  the long term process of illness and disease  ● Causes  ○ Cognitive perceptual distortions? 
○ Focus attention on sensations, makes sensations seem more intense than they 
really are, increased anxiety causes additional physical symptoms, in a vicious 
cycle 
○ Familial history of IAD  ● Treatment   ○ Challenge illness-related misinterpretations 
○ Provide more substantial and sensitive reassurance; attend to the “meaning” of the 
symptoms   ○ Taking the time to explain the nature of IAD to patient  
○ Support groups 
○ Medications maybe 
 
Somatic Symptom Disorder: Additions and Changes to DSM-5 Criterion 
● Criterion A- one or more somatic symptoms that are  distressing  or result in significant  disruption of daily life   ○ Removed specification that symptoms must begin before age 30 and occur over  several years  ○ Added specification that symptoms may be distressing 
○ In DSM-5, individuals do not need to display a minimum number of symptoms, 
nor do their symptoms need to fall into specific categories   ● Criterion B (new in DSM-5)- excessive thoughts, feelings, or behaviors related to the  somatic symptoms or associated health concerns as manifested by at least one of the 
following 
○ Disproportionate and persistent thoughts about the seriousness of one’s symptoms 
○ Persistently high level of anxiety about health or symptoms  
○ Excessive time and energy devoted to these symptoms or health concerns 
● Criterion C (new in DSM-5)- although any one symptom may not be continuously  present, the state of being symptomatic is persistent (typically more than 6 months)   
Factitious Disorder (Munchausen Syndrome) 
● Falsification of medical or psychological symptoms that can lead to others viewing the  individual as more impaired leading to excessive clinical intervention    ● The symptoms are under voluntary control, but there is no obvious reason for voluntarily  producing the symptoms except possibly to receive increased attention and being taken 
care of  
background image ● If the motivation is to get out of work or responsibilities then its “malingering”  ● Two subtypes  ○ Factitious Disorder imposed on self  ■ The person presents to others as ill, impaired or injured  
■ Deceptions might include neurological symptoms (dizziness, seizures), 
placing blood in urine, or ingesting heparin   ■ 1% of hospitalized patients   ○ Factitious Disorder imposed on others  ■ The person presents another person as ill, impaired or injured 
■ Mostly women caring for children 
■ Perpetrators have high rates of abuse  
■ An adult may purposefully make a child sick for the attention and pity 
then  given to the parent  who is causing the symptoms  ■ Parents becomes overly involved in care of the child 
■ Medical staff may at first perceive parent as remarkably caring  
■ Parent will go at great lengths to keep child looking “ill” for the attention  
■ Remove child from environment- child suddenly gets better 
● DSM-5 Criteria:  ○ Falsification of physical or psychological signs of symptoms, or induction of  injury or disease, associated with an identified deception  ○ The individual presents himself or herself to others as ill, impaired, or injured 
○ The deceptive behavior is evident even in the absence of obvious external rewards 
○ The behavior is not better explained by another mental disorder, such as 
delusional disorder or another psychotic disorder   
Conversion Disorder AKA Functional Neurological Symptom Disorder by Neurologis 
● Overview and defining features  ○ Physical or neurologic malfunctioning without any physical or organic pathology  to account for the malfunction  ○ Malfunctioning often suggests that some type of  neurological disease  is affecting  sensory-motor systems   ■ Going blind when all visual processes are normal 
■ Experiencing paralysis when there is no neurological damage 
■ Total mutism and loss of sense of touch 
■ Seizures which may be psychological in origin; no significant EEG 
changes can be documented  ● Conversion symptoms are often precipitated by marked stress; not uncommon in soldiers  exposed to combat  ○ I.e witnessed terrible event so now he can't see 
background image ● Though people with conversion symptoms can usually function normally, they seem  unaware of this ability or of sensory input  ○ People with the conversion symptom of blindness can usually avoid objects in  their visual field but will tell you they can’t see them  ○ People may be able to jump up in an emergency and then be astounded by it   ● May occur in conjunction with other disorders  ○ Anxiety and mood disorders are common  ● Rare in mental health settings (patient is more likely to consult with a neurologist) 
● 2-3 times more common in women 
● Occurs in males at times of extreme stress 
● May be tough to distinguish between people who are truly experiencing conversion 
symptoms and  malingerers  who are good at faking it   ● DSM-5 Criteria  ○ One or more symptoms of altered voluntary motor or sensory function 
○ There is evidence of incompatibility between the symptoms reported by the 
patient and recognized neurological or medical conditions  ○ Symptom or deficit is not better explained by another medical or mental disorder 
○ The symptom or deficit causes clinically significant distress or impairment in 
functioning or warrants medical evaluation   ○ Specify  ■ Weakness or paralysis 
■ Abnormal movement 
■ Swallowing symptoms 
■ Speech symptoms 
■ Seizures 
■ Sensory loss 
■ Sensory impairments 
■ Mix of these 
● Causes  ○ Individual experiences a stressful/traumatic event 
○ Because running away is unacceptable, getting sick is substituted  
○ Getting sick on purpose is unacceptable, so this motivation is detached from a 
person’s reality   ○ Because the conversion symptoms allow the person to escape from reality they  continue until the problem (stressful/traumatic event) is addressed  ● Treatment  ○ Core strategy is identify and address reaction to the stressful/traumatic life event 
○ Remove sources of secondary gain for symptoms  
 
background image Psychological Factors Affecting Other Medical Conditions  ● Overview  ○ Factors such as stress, coping style, maladaptive health behaviors, poor adherence  to medical recommendations, or denial of symptoms  exacerbate a medical  condition  ■ Stress increasing risk for hypertension 
■ Depression impacting experience of pain 
■ Anxiety exacerbating asthma  
■ Denial interfering with taking care of acute chest pain 
○ Differential- if the psychological or behavioral symptoms develop  in response  to a  medical condition then it's more appropriate for an adjustment disorder diagnosis   ● DSM-5 Criteria  ○ A medical symptom or condition is present 
○ Psychological or behavioral factors adversely affect the medical condition in one 
of the following ways  ■ The factors influence the course of the medical condition 
■ The factors interfere with treatment (missed appointments) 
■ The factors constitute additional health risks for the person 
■ The factors influence underlying pathophysiology  
○ The psychological and behavioral factors in B are not better explained by another  mental disorder   ■ I.e. panic disorder, PTSD   
An Overview of Dissociative Disorders 
● Overview  ○ Involve severe alterations or detachments 
○ Often due to severe stress, trauma, abuse 
○ Affect identity, memory, and/or consciousness 
○ Severe form of normal perceptual experiences 
○ Depersonalization- distortion in perception of your own reality 
○ Derealization- losing a sense of the reality of the external world; things seem to 
change shape or size; you dissociate from reality  ● Types of DSM-5 Dissociative Disorders  ○ Depersonalization-Derealization Disorder 
○ Dissociative Amnesia/Dissociative Fugue 
○ Dissociative Identity Disorder 
 
Depersonalization Disorder 
● Overview and Defining Features 
background image ○ Severe and frightening feelings of unreality and detachment 
○ These dominate and interfere with life functioning 
○ Problem involves depersonalization and derealization 
● Facts and Stats  ○ High comorbidity with anxiety and mood disorders 
○ Onset typically around age 16 
○ Usually runs a lifelong chronic course 
● Causes  ○ Cognitive deficits in attention 
○ Cognitive deficits in short term memory 
○ Cognitive deficits in spatial reasoning 
○ Deficits related with tunnel vision and mind emptiness 
○ Such persons are easily distracted  
● Treatment- Little is known   
Dissociative Amnesia and Dissociative Fugue  
● Overview and Defining Features  ○ Several forms of psychogenic memory loss 
○ Generalized type- Inability to recall anything, including their identity 
○ Localized or selective type- Failure to recall specific (usually traumatic) events 
○ Dissociative Amnesia now includes dissociative fugue as a subtype in which the  amnesia is accompanied by either purposeful or confused travel   ■ I.e leaving or wandering away from home 
■ Overview and Defining Features 
● Related to dissociative amnesia 
● Take off to a new place 
● Unable to remember the past 
● Unable to remember how they arrived at a new location 
● Often assume a new identity 
● Facts and Stats- Dissociative Amnesia and Fugue  ○ Usually begin in adulthood 
○ Both show rapid onset and dissipation 
○ Both are mostly seen in females 
● Causes  ○ Little is known 
○ Trauma and life stress can serve as triggers 
● Treatment   ○ Most get better without treatment  
○ Most remember what they have forgotten 

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School: Boston University
Department: OTHER
Course: Abnormal Psychology
Professor: Donna Pincus
Term: Spring 2017
Tags: abnormal psych
Name: Study Guide Exam 2
Description: These notes cover what will be on our next exam.
Uploaded: 03/31/2017
52 Pages 74 Views 59 Unlocks
  • Better Grades Guarantee
  • 24/7 Homework help
  • Notes, Study Guides, Flashcards + More!
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